COCP Guideline

Question 1

Tailored CHC regime - licensed or not?

Answer 1

NOT licensed, but supported by FSRH

Women should have clear written/digital info re: tailored regimes

Question 2

How long after stopping an enzyme inducer can contraceptive effectiveness be reduced?

Answer 2

28 days

Question 3

What is the first-line CHC to minimise cardiovascular risk?

Answer 3

</= 30microgram EE + either levonorgestrel or norethisterone

Question 4

Up to what age can CHC be used?

Answer 4

50y/o

Question 5

First generation progestogens:

Answer 5

Norethisterone

Question 6

Second generation progestogens:

Answer 6

Levonorgestrel

Question 7

Third generation progestogens:

Answer 7

1. Desogestrel
2. Gestodene
3. Norgestimate

Question 8

Fourth generation progestogens:

Answer 8

1. Drospirenone (DRSP)
2. Dienogest,
3. Nomegestrol acetate

Question 9

Components of combined transdermal patch:

Answer 9

33.9 μg EE
203 μg
norelgestromin
(3rd gen)
/day

Question 10

Components of combined vaginal ring:

Answer 10

15 μg EE
120 μg etonogestrel (3rd gen)
/day

Question 11

If a patient using an enzyme-inducing drug chooses to use an COCP despite advice, what dose should be used?

Answer 11

50 μg EE (30+20) - unknown effect on VTE

70 μg EE may be used after SPECIALIST ADVICE

Question 12

When may use of CHC and enzyme-inducing drugs be more flexible?

Answer 12

When short-term use - <2/12

Question 13

How do CHC and lamotrigine interact?

Answer 13

• Reduced seizure control whilst using CHC - reduction in levels
• During the HFI, lamotrigine toxicity

Question 14

What are the D&V rules for COCP?

Answer 14

Vomiting within 3 hours
Severe diarrhoea >24 hours

Question 15

Can COCP alleviate vasomotor Sx?

Answer 15

Overall, limited evidence suggests that use of COC can help alleviate vasomotor symptoms in
perimenopausal women

Question 17

What proportion of women have spontaneous return of menstruation within 90 days?

Answer 17

98.9%

Question 18

How many months supply of NuvaRing can be dispensed at one time?

Answer 18

3/12

Question 19

What are the different types of combined pills available in the UK?

Answer 19

Cilest - EE 35/norgestimate - discontinued
Cilique EE 35/norgestimate
Lizinna EE 35/norgestimate

Femodene - EE 30/gestodene

Femodette - EE 20/gestodene

Marvelon - EE 30/desogestrel
Gederal 30 - EE 30/desogestrel

Mercilon - EE 20/desogestrel
Gederal 20 - EE 20/desogestrel

Microgynon 30 - EE 30/levonorgestrel
Ovranette - EE 30/levonorgestrel
Rigevidon - EE 30/levonorgestrel
Maexeni - EE 30/levonorgestrel

Yasmin - EE 30/drospirenone
Luette - EE 30/drospirenone

Eloine EE 20/drospirenone - 24 active pink; 4 inactive white

Zoely - Estradiol hemihydrate/Nomegestral acetate - 24 active tablets; 4 yellow inactive tablets

Qlaira - Estradiol valerate/dienogest - 26 coloured active tablets; 2 white inactive tablets

Drovelis - Esterol/Drospirenone - 24 pink active tablets; 4 white inactive tablets

Question 20

What does Zoely contain?

Answer 20

Estradiol hemihydrate/Nomegestral acetate

24 white active tablets
4 yellow inactive tablets

24 hour window period

Question 21

What does Qlaira contain?

Answer 21

Estradiol valerate/dienogest

26 coloured active tablets
2 white inactive tablets

12 hour window period

Question 22

What does Drovelis contain?

Answer 22

Esterol/Drospirenone

24 pink active tablets
4 white inactive tablets

Esterol = E4 - 10-20x less potent than EE, and also less potent than estradiol (E2)

24 hour window period

Question 23

What does Cilest, Cilique and Lizinna contain?

Answer 23

EE 35/norgestimate

12 hour window period

Question 24

What does Femodene contain?

Answer 24

EE 30/gestodene

12 hour window period

Question 25

What does Femodette contain?

Answer 25

EE 20/gestodene 12 hour window period

Question 26

What do Marvelon and Gederal 30 contain?

Answer 26

EE 30/desogestrel 12 hour window period

Question 27

What do Mercilon and Gederal 20 contain?

Answer 27

EE 20/desogestrel 12 hour window period

Question 28

What do Microgynon 30, Ovranette, Rigevidon and Maexeni contain?

Answer 28

EE 30/levonorgestrel 24 hour window period - Rigevidon, Maexeni 12 hour window period - Microgynon 30, Ovranette

Question 29

What does Yasmin and Lucette contain?

Answer 29

EE 30/drospirenone 12 hour window period

Question 30

What does Eloine contain?

Answer 30

EE 20/drospirenone 24 active pink, 4 inactive white tablets 24 hour window period

Question 31

When should TFTs be checked after initiating CHC?

Answer 31

6/52

Question 32

Which is the only type of CHC that cannot be quickstarted where pregnancy cannot be reasonably excluded?

Answer 32

Containing cyproterone acetate